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Publications

Journal Article Review Epublish 23 citations

PubMed: 37298731 DOI: 10.3390/ijms24119780

Upgrading Treatment and Molecular Diagnosis in Endometrial Cancer-Driving New Tools for Endometrial Preservation?

Int J Mol Sci 24(11)

Authors: Miriam Dellino, Marco Cerbone, Antonio Simone Laganà, Amerigo Vitagliano, Antonella Vimercati, Marco Marinaccio, Giorgio Maria Baldini, Antonio Malvasi, Ettore Cicinelli, Gianluca Raffaello Damiani, Gerardo Cazzato, Eliano Cascardi

Affiliations

  • Obstetrics and Gynaecology Unit, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", 70124 Bari, Italy.
  • Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
  • MOMO' FertiLIFE IVF Center, 76011 Bisceglie, Italy.
  • Department of Emergency and Organ Transplantation, Pathology Section, University of Bari "Aldo Moro", 70124 Bari, Italy.
  • Department of Medical Sciences, University of Turin, 10124 Turin, Italy.
  • Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, 10060 Candiolo, Italy.

Abstract

One emerging problem for onco-gynecologists is the incidence of premenopausal patients under 40 years of age diagnosed with stage I Endometrial Cancer (EC) who want to preserve their fertility. Our review aims to define a primary risk assessment that can help fertility experts and onco-gynecologists tailor personalized treatment and fertility-preserving strategies for fertile patients wishing to have children. We confirm that risk factors such as myometrial invasion and The International Federation of Gynecology and Obstetrics (FIGO) staging should be integrated into the novel molecular classification provided by The Cancer Genome Atlas (TCGA). We also corroborate the influence of classical risk factors such as obesity, Polycystic ovarian syndrome (PCOS), and diabetes mellitus to assess fertility outcomes. The fertility preservation options are inadequately discussed with women with a diagnosis of gynecological cancer. A multidisciplinary team of gynecologists, oncologists, and fertility specialists could increase patient satisfaction and improve fertility outcomes. The incidence and death rates of endometrial cancer are rising globally. International guidelines recommend radical hysterectomy and bilateral salpingo-oophorectomy as the standard of care for this cancer; however, fertility-sparing alternatives should be tailored to motivated women of reproductive age, establishing an appropriate cost-benefit balance between childbearing desire and cancer risk. New molecular classifications such as that of TCGA provide a robust supplementary risk assessment tool that can tailor the treatment options to the patient's needs, curtail over- and under-treatment, and contribute to the spread of fertility-preserving strategies.

MeSH

Diabetes Mellitus, Fertility, Incidence, Risk Assessment, Fertility Preservation, Neoplasms, Classification, Risk Factors, Diagnosis, Therapeutics, Endometrial Neoplasms, Gynecologists

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